What happens if you go overdue?

Your doctor will confirm your gestational age either by revising your last menstrual period date or your early ultrasound. Then he will inspect your cervix to check its readiness for delivery by checking its consistency and length and dilation. Your doctor might offer to do a membrane sweep if the cervix is partially dilated, this induces the release of prostaglandins which can help start labor. If this does not work for you, you can decide with your doctor either to start labor induction or go for a cesarean section at once.

Pain relief during labor

Pain relief in labor

The pain during contraction is caused by dilation of the cervix by uterine contractions. Labor pain is different from one mother to the other and is also different from each delivery to the other, this is why different pain control plans have been developed and individualized according to each mother’s sense of pain, personal preference and what is suitable for her and her baby’s health. Some pregnant women change their decision of pain relief during the course of labor itself from one type to another. others think that they don’t deserve to be mothers if they don’t stand the pain of delivery. Our personal advice is not to mix up your pain endurance ability with your sense of motherhood.

  • Analgesic drugs :They provide pain relief over the entire body without causing loss of consciousness. Often given as an injection or combined with other drugs to relieve tension or nausea, they act on the whole nervous system. They may cause drowsiness and make it hard to concentrate; because these drugs can slow the baby’s reflexes and breathing at birth, they are usually avoided just before delivery.
  • Local or regional Anetheistic drugs: They make you loose sensations and with some kinds you may also lose consciousness.
  • Epidural Block: it is a form of local anesthesia which numbs the lower half of the body. It is injected into the lower back, where the nerves that receive sensations from the lower body meet the spinal cord.
  • Local anesthesia: it is usually injected into the vagina or area surrounding it and they are useful when the doctor has to make an episiotomy or fix any tears that might have occurred during birth
  • General anesthesia: If used the mother will not be awake or feel any pain during delivery. It is given in one of two ways: through a face mask or through IV line. Serious side effects, though rare can occur.
  • Alternative methods:    Lamaze technique: Lamaze teaches pregnant women that pregnancy is something natural and it tries to change their comprehension of pain by training them to link pain to breathing or meditation so that by time pain can be substituted by positive feeling. It is all supervised by a coach. Bradley method: the coach is the father himself and it consists of the same methods of lamaz plus good nutrition of the mother.

Induction of labor

Induction of labor

Induction involves use of drugs or procedures that starts uterine contraction to terminate pregnancy and start labor. It is used in cases where pregnancy has to be terminated (pregnancy complications like hypertension, diabetes, heart problems , rupture of membranes with no associated contractions) or when  normal labor contractions didn’t start in due time.

Normal vaginal delivery

Normal vaginal delivery

It occurs when the baby’s time inside the uterus is over and it is coming out of the uterus vaginally. The uterus starts to contract(he uterus tightens and relaxes at regular intervals, causing the abdomen to feel hard, then soft. which make the cervix thin out (efface) and open as wide as it can (dilate).  Contractions also help in pushing the baby deeper into the pelvis till it comes through the vagina. Normal labor occurs on 3 steps:

First stage

It takes about 8-12 hours in primigravida (First time to deliver) and shorter in multigravidas (Delivered before). It is the part where the cervix dilates to 10 cm full dilation. Don’t push down and do your first stage breathing exercises.

Second stage

It takes about 30-60 minutes. The baby comes out here. It occurs in a well prepared operative theater. It is preferred to perform the breathing exercises in this stage. The doctor might a small incision between the vagina and the anal opening (episiotomy). It is done to enlarge the vaginal opening to facilitate an easy delivery. Not all deliveries need an episiotomy

Third stage

It takes about 10-30 minutes. The placenta comes out in this stage. When the placenta separates a gush of blood and the cord comes out more. Your doctor massages your abdomen and pulls the placenta out then massages again to help the uterus to contract. The doctor will fix the episiotomy at that time.

Fetal follow-up

The fetus should be followed up all the time of labor using sonic aid Doppler to hear the fetal heart beats or CTG to draw the fetal movements against uterine contractions.

What are the signs of labor?

Signs of labor

If any of the following signs happen call your doctor and head to the hospital immediately:

  • Contractions in your lower abdomen which increase in strength and frequency. The interval between contractions decreases from 30 min to 15 min to 10 min and then less and usually becomes more felt in the lower abdomen. Each contraction lasts from 30-70 seconds.
  • Pressure and heaviness in your lower abdomen with the urge to pee.
  • Expulsion of a brownish mucus discharge (THE SHOW: mucus which closed the cervix during pregnancy, thus denoting the starting of cervical opening and dilation)
  • Water flowing out of your vagina.

Baby preparation

Labor bag preparation

  • A baby sleeping crib with a blanket
  • Baby walking stroller
  • Easy to wear going out outfit (better with buttons from top to bottom or two pieces)
  • Cotton hats for the summer sun or winter cold
  • Gloves to protect the face from involuntary hand movements
  • Soft socks and shoes. Try to choose a material that does not cause allergy to the baby
  • Under wear, Food covers
  • Diaper changing: foldable plastic pad for changing outside the house, baby diapers, cream to put on before wearing the new diaper, wipes
  • Pacifiers which comply with orthodontic standards to protect the jaw,
  • milk bottles of large size.
  • A nipple which comply with orthodontic standards and has the right flow (slow, medium and fast).
  • Sterilizing choice of a boiling pot, antimicrobial solutions or microwave/steam sterilizer.  , A Water heater and brushes to clean the bottles,
  • baby shampoo, baby lotion, baby sponge, baby tub, soft towels, water temperature thermometer, Special soap for washing the baby’s cloth, Nose suction , and soft hair comb and brush.